In my Houston podiatry practice, I see a lot of patients who are experiencing heel pain. Heel pain is most often caused by plantar fasciitis, which is also known as heel spur syndrome. Plantar fasciitis is a painful inflammation of the ligament that extends from the heel to the toes. In other instances, pain in the back of the heel may be due to an inflammation of the Achilles tendon.

How Heel Pain Manifests

Heel pain can begin very intermittently, but, over time, become more consistent, more intense, and can even spread to the other foot. For this reason, early intervention is best when it comes to treating heel pain.

There is some good news when it comes to heel pain: plantar fasciitis generally responds well to conservative, non-surgical treatment, including stretching exercises, medications, padding and strapping, orthotic devices, night splints, and physical therapy. In fact, a recent study in the Washington Post showed that plantar fasciitis patients being treated with non-invasive exercises were 1.6 times more likely to be cured than those patients receiving cortisone injections!

Why You Can't Leave Heel Pain Untreated

As we've just explored, the pain of plantar fasciitis should resolve with proper, minimally invasive treatment; the healing process may be slow, but the problem does eventually improve or go away completely. But, for some patients, their heel pain is not reflective of plantar fasciitis—it can be the symptom of a far more serious problem.

According to Dr. Rick Positano's sweeping study on heel pain, after looking at the feet of 175 people who had been diagnosed with plantar fasciitis, 34% of those people actually had a torn ligament, while 15% had a type of benign growth known as a plantar fibroma. While none of the conditions are life threatening, they should each be treated very differently. In fact, a wrong treatment could actually make some of the conditions worse (For example, doing plantar fasciitis stretches on a torn ligament will only exacerbate the injury.)

When you see study results like that, you’ll understand why I always begin treatment with a diagnostic exam to ensure we are treating the correct injury. Only after securing an accurate diagnosis do I begin working towards a repair--an even then, I start with the least invasive treatment possible for my patients. It is only if conservative treatment fails that I will try more invasive procedures, like injections or shockwave therapy, to reduce heel pain. What’s great about shockwave therapy is that it aids in eliminating the inflammation of plantar fasciitis without surgery. As a result, only a very small percentage of patients in my practice require surgery to resolve their heel pain.

As with almost every foot condition, early treatment will make a huge difference in the types of therapies that will be effective for your treatment plan. If you are experiencing heel pain, schedule an appointment with Dr. Andrew Schneider today!